Wednesday, June 03, 2015

The Unconsummated Marriage and the Childless Couple

Surprisingly, an unconsummated marriage is a common course of childlessness. If you notice, I didn’t say infertility; this is because infertility refers only to couples who have failed to conceive after having regular intercourse for at least one year. So why are couples unable to achieve vaginal intercourse?

A Common Problem

When I tell these patients that this is quite a common problem, many are taken aback They feel that they are incompetent freaks and that there must be something intrinsically wrong with them if they are unable to perform even such a basic and natural biological activity. What’s probably even more surprising is that a number of doctors tend to miss this diagnosis. Most doctors simply assume that in the sexually permissive landscape we live in today, all couples know how to have intercourse.

A Tricky Situation

They simply assume that the couple is having normal intercourse and that they are being approached to resolve their fertility issues. Most of these couples are reluctant to proactively tell the doctor that they have not been able to achieve intravaginal ejaculation; this is because they are ashamed of the fact and don’t like to admit it either to themselves or their doctor. Thus, this becomes a very tricky situation and the doctor has to be extremely patient, if they want to make the right diagnosis. This isn’t something which can be diagnosed using blood tests or ultrasound scans.

The Reasons

It’s also very difficult for the doctor to elicit this information from the couple in the first few minutes of a hurried consultation; a lot of gentle and careful prodding is required to get the couple to admit there is a problem and talking about it. Before the patients volunteer information, they need to be able to trust the doctor completely. There are a number of reasons for an unconsummated marriage, such as:

• Erectile dysfunction• Vaginismus• Plain ignorance

If both partners are virgins, they may not have an idea as to how to have sex. The only way they can get this information is from the Internet; however a lot of this sexual information comes from unreliable pornographic sites and the couple gets even more confused.

Solving the Problem

The good thing is that this is a relatively easy problem to solve, as it doesn't require much medical intervention. Of course, some doctors also find this much more difficult to treat, as they prefer to simply write a prescription rather than sit the patients down and educate that in order to have a child, they will first have to consummate the marriage. This requires a great deal of counseling and the doctor will have to be empathetic. The patients should not feel that the doctor is being judgmental or jeering at them because they don’t even know how to have sex.

The Problem

Some doctors add fuel to the fire by reaching the diagnosis that the reason for the failed penetration is a very tight vagina. Typically, this condition can be treated by an operation called a Fenton’s in which the vagina is cut to enlarge it. Some other doctors will simply fob off the patient to a psychiatrist, as they aren’t interested in handling these psychological problems.

What Can Be Done

• Doctors can prescribe information therapy, by encouraging these couples to buy books, so they can educate themselves as to how intercourse is normally performed. This can go a long way towards helping them to resolve their issues• Couples should be encouraged to explore their own sexuality, by performing mutual masturbation• They can use sexual toys such as vibrators and liquid paraffin

Once they are comfortable with their own sexuality, many of these couples are able to get pregnant in their own bedroom, without any further assistance from the doctor.